Research Paper Volume 11, Issue 18 pp 7605—7619
Adherence to a healthy lifestyle counteracts the negative effects of risk factors on all-cause mortality in the oldest-old
- 1 School of Public Health, Tianjin Medical University, Tianjin 300070, P.R. China
- 2 Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm SE-17177, Sweden
- 3 Department of Biostatistics, School of Public Health, Yale University, New Haven, CT 06520, USA
Received: July 3, 2019 Accepted: September 5, 2019 Published: September 16, 2019
https://doi.org/10.18632/aging.102274How to Cite
Copyright © 2019 Cao et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
In the study, we examined the extent to which the harmful effects of risk factors on all-cause mortality can be counteracted by healthy lifestyle practices in the oldest-old (80 years of age and older). A total of 17,660 oldest-old from China were followed up for up to 10 years. The data were analyzed using the Cox proportional hazard model with adjustment for potential confounders. We found that having a rural residence, not being married, having lower economic status, physical disability, impaired cognitive function, or comorbidity were all associated with an elevated risk of mortality. Using these factors, we computed a weighted “risk score.” Because never smoking, never drinking, doing physical exercise, having an ideal diet, and a normal weight were independently associated with lower mortality, we also combined them to compute a weighted “protection score.” Both scores were divided into lowest, middle, and highest groups using their tertiles. In joint effect analyses, participants with the combined highest-risk score and lowest-protection score profile had a nearly threefold higher joint death risk. These analyses show that adherence to a healthy lifestyle counteracts the negative effect of risk factors on all-cause mortality in the oldest-old by more than 20%.
Abbreviations
ADL: Activities of Daily Living; BMI: body mass index; BP: blood pressure; CI: confidence interval; HR: hazard ratio; MMSE: Mini-Mental State Examination; PAF: population attributable fraction; SD: standard deviation.